Dr. Kodjo Senah from the Department of Sociology at the University of Ghana
conducted a study on the effect of cultural perceptions on the use of
pharmaceuticals. The study was conducted in Niiman, a village on the western
coast of Ghana, 36 km from the capital city of Accra. Niiman has little social
infrastructure, irregular water supply, poor sanitation, and high endemicity of
environmental, parasitic, and infectious diseases. Despite the severe health
problems, there are no public health outposts. Instead, Niiman is covered by a
fortnightly primary health care outreach program on immunization and
ante-/post-natal care with large monetary charges. To compensate for the lack
of public health care, two drug stores that are only licensed to sell
over-the-counter medications often sell antibiotics and other prescription
drugs. Senah found that villagers knew the effects of different pharmaceuticals
and consequently would use drugs to treat specific symptoms rather than the
condition for which the drug is intended. There are also five traditional
healers and two traditional birth attendants. Senah observed that villagers
understood the difference between pharmaceuticals and traditional medicines.
Because of low availability, high costs, and general distrust of
pharmaceuticals, villagers also used self-medication. If medications were
needed, they used traditional medicines more often than pharmaceuticals. Senah
also observed that adults in Niiman developed considerable stoicism towards
their own illnesses as a means of coping with limited medical resources. He
concluded that the poverty in Niiman promoted dependence on ethno-medicines and
that developing a rational drug policy was not enough to ensure essential drugs
were available. The problem in Niiman was not a lack of drugs; it was a lack of education about use, drug monitoring, and medical infrastructure. (Abstract by Flannery Bowman, 2013)